Hypomethylating agent versus venetoclax combination: an electronic health records-based target trial emulation among Asian elderly patients with newly diagnosed acute myeloid leukaemia in Hong Kong.

IF 3.4 3区医学 Q2 HEMATOLOGY

Therapeutic Advances in Hematology Pub Date : 2025-07-04 eCollection Date: 2025-01-01 DOI:10.1177/20406207251346914

Qiwen Fang, Chi Yeung Fung, Jiaqi Wang, Wing Hei Lai, Raymond S M Wong, Bonnie C S Kho, June S M Lau, Vivien W M Mak, Chung Yin Ha, Xue Li, Anskar Yu-Hung Leung

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引用次数: 0

Abstract

Background: The pivotal trial on venetoclax and hypomethylating agents in unfit elderly acute myeloid leukaemia (AML) has got FDA approval. However, Asian patients were under-represented and showed no survival advantage.

Objective: We aimed to compare overall survival and healthcare resource utilisation in elderly patients newly diagnosed with AML, receiving venetoclax with hypomethylating agents versus hypomethylating agents alone.

Design: Target trial emulation.

Methods: Propensity score matching balanced the baseline characteristics. Kaplan-Meier curve and Cox regression compared overall survival. Negative binomial regression assessed healthcare resource utilisation with time offset.

Results: Venetoclax plus hypomethylating agents treatment conferred superior overall survival in patients with AML ⩾60 years old and significantly reduced transfusion requirement compared to those receiving hypomethylating agents alone. The difference was particularly prominent among patients ⩾75 years old.

Conclusion: Compared to hypomethylating agent alone, venetoclax plus hypomethylating agent benefits elderly patients with AML on overall survival and healthcare resource utilisation.

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低甲基化剂与venetoclax联合用药：香港亚洲老年新诊断急性髓性白血病患者基于电子健康记录的目标试验模拟

背景：venetoclax和低甲基化药物治疗老年急性髓性白血病（AML）的关键性试验已获得FDA批准。然而，亚洲患者的代表性不足，没有表现出生存优势。目的：我们旨在比较新诊断为AML的老年患者，接受venetoclax联合低甲基化药物治疗与单独接受低甲基化药物治疗的总生存率和医疗资源利用情况。设计：目标试验仿真。方法：倾向评分匹配平衡基线特征。Kaplan-Meier曲线和Cox回归比较总生存率。负二项回归评估了随时间偏移的医疗资源利用情况。结果：与单独接受低甲基化药物的患者相比，Venetoclax加低甲基化药物治疗在小于60岁的AML患者中赋予了更高的总生存期，并且显着减少了输血需求。这种差异在小于75岁的患者中尤为突出。结论：与单纯使用低甲基化药物相比，维托克拉克斯联合低甲基化药物在老年AML患者的总生存期和医疗资源利用方面均有优势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Hematology HEMATOLOGY-

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

7 weeks

期刊介绍： Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.